Eksternal Dakriyosistorinostomide Mukozal Flep Tekniğinin Cerrahi Başarı Üzerine Etkisi: H Flep mi? U Flep mi?
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Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
Lakrimal kese ve burun mukozasında oluşturulan “H” ve “U” flep tekniklerinin eksternal dakriyosistorinostominin (DSR) başarısı üzerine etkisini karşılaştırmak.
Yöntem: Distal nazolakrimal kanal tıkanıklığı tanısı ile eksternal DSR ameliyatı yapılan 50 olgunun (36 bayan, 14 erkek) 50 gözü çalışmaya alındı. Olgular ameliyat olma sıralarına göre iki gruba ayrıldı. Önce ameliyat olan 25 vaka birinci gruba (H-flep grubu), sonra ameliyat olan 25 vaka ikinci gruba (U-flep grubu) alındı. Birinci gruptaki hastalarda kese ve nazal mukozada “H” şeklinde kesi ile ön ve arka flepler hazırlandı. İkinci gruba ise sadece “U” şeklinde kesi ile ön flepler hazırlandı. Tüm olgulara flep tekniği dışındaki tüm cerrahi basamaklar aynı şekilde yapıldı.
Bulgular: Birinci grup yaşları 18-60 (ort. 42.7±14.3) arasında değişen 25 olgu, ikinci grup ise yaşları 22-65 (ort. 44.2±13.4) arasında değişen 25 olgudan oluşturuldu. Birinci gruptaki olgular 7-14 (ort. 10.5±3.6) ay, 2. gruptaki olgular 5-13 (ort. 11.4±4.2) ay takip edildiler. Birinci gruptaki (H-flep) 25 olgunun 21’inde (%84) cerrahi başarı sağlanırken, 4’ünde (%16) başarısızlık saptandı. İkinci gruptaki (U-flep) tüm olguların erken ve geç postoperatif dönemde yapılan tüm kontrollerinde lavajla kanalın açık olduğu ve hastaların preoperatif tüm şikâyetlerinin kaybolduğu saptandı.
Sonuç: “U” flep tekniği ile eksternal DSR’nin cerrahi başarı oranının artabileceğini düşünmekteyiz. Bu flep tekniği ile büyük lakrimal keselerde olduğu gibi küçük lakrimal keselerde de yeterli büyüklükte ön fleplerin oluşturulması mümkün olmaktadır.
To compare the effects “H” and “U” flap technique on surgical success in external dacryocystorhinostomy (DCR). Method: This study included 50 eyes of 50 patients (36 women, 14 men) with the diagnosis of distal nasolacrimal duct obstruction. All cases underwent external dacryocystorhinostomy (DCR). The patients were divided into 2 groups according to their order of operation. The first 25 cases were included in Group 1 and the next 25 cases were included in Group 2. In the first group, "H" shaped incision was made in the sac and nasal mucosa then patients assigned to anterior and posterior flap anastomosis. In the second group only anterior flap was prepared by "U" shaped incision was made in the sac and nasal mucosa and the patients assigned to only anterior flap anastomosis. All surgical steps were performed in the same way in all cases, except for the flap technique. Silicone intubation was not performed in any patient. Results: The mean ages were 42.7±14.3 (range: 18-60) and 44.2±13.4 (range: 22-65) in group 1 and 2, respectively. The mean follow-up period was 10.5±3.6 (range: 7-14 mo.) and 11.4±4.2 (range: 5-13 mo.) months in group 1 and 2, respectively. Lacrimal drainage pathway was open in twenty one patients (%84) in Group 1 and 25 patients (%100) in Group 2, at last post-operative examination and all preoperative complaints were disappeared. Conclusion: The rate of surgical success may increase with U-flap technique in DCR surgery. Prepearing of large enough flaps is possible with this technique in the patients with small sacs as well as the patients with big sacs.
To compare the effects “H” and “U” flap technique on surgical success in external dacryocystorhinostomy (DCR). Method: This study included 50 eyes of 50 patients (36 women, 14 men) with the diagnosis of distal nasolacrimal duct obstruction. All cases underwent external dacryocystorhinostomy (DCR). The patients were divided into 2 groups according to their order of operation. The first 25 cases were included in Group 1 and the next 25 cases were included in Group 2. In the first group, "H" shaped incision was made in the sac and nasal mucosa then patients assigned to anterior and posterior flap anastomosis. In the second group only anterior flap was prepared by "U" shaped incision was made in the sac and nasal mucosa and the patients assigned to only anterior flap anastomosis. All surgical steps were performed in the same way in all cases, except for the flap technique. Silicone intubation was not performed in any patient. Results: The mean ages were 42.7±14.3 (range: 18-60) and 44.2±13.4 (range: 22-65) in group 1 and 2, respectively. The mean follow-up period was 10.5±3.6 (range: 7-14 mo.) and 11.4±4.2 (range: 5-13 mo.) months in group 1 and 2, respectively. Lacrimal drainage pathway was open in twenty one patients (%84) in Group 1 and 25 patients (%100) in Group 2, at last post-operative examination and all preoperative complaints were disappeared. Conclusion: The rate of surgical success may increase with U-flap technique in DCR surgery. Prepearing of large enough flaps is possible with this technique in the patients with small sacs as well as the patients with big sacs.
Açıklama
İnönü Üniversitesi Tıp Fakültesi Dergisi 2012;19(2):71-4.
Anahtar Kelimeler
Eksternal Dakriyosistorinostomi, Mukozal Flep Tekniği, U-Flep, H-Flep
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Gündüz, Abuzer; Cumurcu, Tongabay; Demirel, Soner ;Özsoy, Ercan; (2012) Eksternal Dakriyosistorinostomide Mukozal Flep Tekniğinin Cerrahi Başarı Üzerine Etkisi: H Flep mi? U Flep mi?İnönü Üniversitesi Tıp Fakültesi Dergisi 2012;19(2):71-4.
